People communicate through words and with body language---their gestures, tone of voice, facial expression, posture, and touch. Alzheimer's disease interferes first with a person's understanding of words. When word skills are impaired, body language becomes extremely important in delivering a message. In the early stages of the disease, persons with Alzheimer's are aware of the gaps in their communication. They may work very hard to cover them up. They may make up stories to cover missing memories, or become anxious or indignant when they are unable to communicate accurately. Family can unwittingly add to their distress when they try to correct the person or they show alarm or distress.

Suggestions for More Effective Communication

Get the person's attention---establish eye contact before speaking.

Speak clearly and slowly, in short sentences.

Keep the message simple, using one-step commands. (For example, “Come for a walk” and not “Isn't it a nice day for a walk?”)

Encourage and show affection, no matter what is said or not said. If either of you becomes frustrated, take a break and try again later.

Keep your tone of voice warm. Use diversion and humor to overcome resistance.

Repeat or rephrase when needed. Show no irritation about having to repeat.

Offer suggestions if the person can't find the words. Questions answered with the simple choices work best. (For example, “Would you rather ride in the chair or walk?”)

Say exactly what you mean in a simple, concrete way.

When dealing with problem issues, give positive directions rather than offering choices. (For example, “It is time to take a shower” not “Would you like to take a shower?”)

Enhance what you say with physical clues and gestures. Make use of your body language.

Many things can be accomplished despite the communication problems of Alzheimer's if the message is delivered in a cheerful and supportive tone by a person showing warmth and understanding.